Charles William Blanchard, PHD
Individual provider Active NPI Clinical Psychologist · Las Cruces, NM
NPI 1992928469 · NPPES record last updated Jan 14, 2011
Key facts
- NPI
- 1992928469
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Psychologist 103TC0700X
- License
- 622 (NM)
- Practice address
- 3205 Arrowhead Rd
Las Cruces, NM 88011-4786 - Phone
- (575) 521-1725
- Fax
- (575) 521-1725
- NPI assigned
- Apr 11, 2007
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- HHS exclusion list flag
- The National Provider Directory flags this NPI as appearing on an HHS exclusion list.
- Credentials
- Doctor of Philosophy
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 622 | NM | Yes |
Addresses
Primary practice location
3205 Arrowhead Rd
Las Cruces, NM 88011-4786
Mailing address
3205 Arrowhead Rd
Las Cruces, NM 88011-4786
Phone (575) 521-1725
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000F4193 | Medicaid | NM |
Other providers in Las Cruces, NM
- Crystal Blackburn
- Randy Blackmer
- Shayla Blackwood
- Jennifer Michelle Blake
- Alexzandra Leigh Blanchard
- Susie Marie Blanco
- Tara Blanco
- Kristen Blandford
- Colby Blazer
- Dawna Elaine Bleimeyer
All providers in Las Cruces, NM · Clinical Psychologist in New Mexico
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 14, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.